Family Member Terms Agreement
Please review and acknowledge the household terms and responsibilities as a family member.
Full Name of Family Member
*
First Name
Last Name
Relationship to Head of Household
*
Please Select
Child
Parent
Sibling
Spouse/Partner
Other
Age
*
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Agreement Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Agreement End Date (if applicable)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please select your main responsibilities as part of this agreement:
*
Keeping shared spaces clean
Helping with meal preparation
Respecting quiet hours
Participating in family meetings
Communicating schedule changes
Other
Please rate your understanding of the household rules and expectations:
*
1
2
3
4
5
Is there anything you would like to discuss or clarify regarding the terms?
Signature of Family Member (or Parent/Guardian if minor)
*
I Agree and Submit
I Agree and Submit
Should be Empty: